From the Research
Symptoms of Hypernatremia
The symptoms of hypernatremia, which can be caused by a tap water colonic wash, include:
- Non-specific symptoms such as anorexia, muscle weakness, restlessness, nausea, and vomiting 1
- Altered mental status, lethargy, irritability, stupor, and coma 2, 1
- Central nervous system dysfunction (confusion, coma) and pronounced thirst (in awake patients) 2
- Cerebral bleeding and subarachnoid hemorrhage due to acute brain shrinkage 1
- Cell shrinkage and structural changes in cell morphology 3
Causes of Hypernatremia
Hypernatremia is often caused by:
- A relative water deficit occurring with decreased thirst sensation and/or reduced water intake 4
- Excessive sodium intake, although this is rare 4, 2
- Increased loss of free water compared to sodium excretion 2
- Inadequate fluid balance with saline infusions, saline overload, or due to osmotic diuresis 3
Treatment and Management
Treatment of hypernatremia involves:
- Eliminating the causes of hypernatremia and managing body volume and electrolytes 4
- Replacing the loss of free water by hypotonic infusions 2
- Addressing the underlying cause and managing the patient's volume status and osmolality 5, 2
- Avoiding rapid changes in serum sodium concentration to prevent osmotic demyelination syndrome 2, 1